NIPT導入の前後10年間における各出生前遺伝学的検査を解析 ~羊水検査、絨毛検査は減少し、高リスク症例に実施の可能性~

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2026-04-09 成育医療研究センター

国立成育医療研究センターと京都大学らの研究グループは、日本における出生前遺伝学的検査の20年間(2003~2023年)の変化を解析した。2013年のNIPT(非侵襲性出生前遺伝学的検査)導入以降、羊水検査や絨毛検査などの侵襲的検査は大幅に減少した一方、これらの検査での染色体異常検出率は8.4%から20%へ上昇し、高リスク症例に選択的に実施されている可能性が示された。また、全体の検査実施率は約3%から11.5%へ増加し、出生前検査の普及が進んでいることが明らかとなった。本研究は日本の出生前医療の変化を示す重要な基礎データであり、今後の遺伝カウンセリング体制や医療政策の検討に資する成果である。

NIPT導入の前後10年間における各出生前遺伝学的検査を解析 ~羊水検査、絨毛検査は減少し、高リスク症例に実施の可能性~

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日本における出生前遺伝子検査の20年間の動向 Two-decade trends in prenatal genetic testing in Japan

Aiko Sasaki,Takahiro Yamada,Haruhiko Sago,Nahoko Shirato,Akihiko Sekizawa,Kenichiro Hata,Hideaki Masuzaki,Yuko Masuzawa,Toshiyuki Yamamoto,Hiroshi Yoshihashi,Shiro Tanaka,Yuka Shibata,Kanako Koike Fukushima,Kenjiro Kosaki,Shigehito Yamada,Masakazu Nishigaki,Ikuo Konishi & Hidehiko Miyake
Journal of Human Genetics  Published:02 March 2026
DOI:https://doi.org/10.1038/s10038-026-01465-y

Abstract

Prenatal genetic testing in Japan has undergone major changes over the past 2 decades. Maternal serum screening (MSS), amniocentesis (AC), and chorionic villus sampling (CVS) have been the principal tools used to identify fetal chromosomal abnormalities. Recently, non-invasive prenatal testing (NIPT) has reshaped clinical decision-making. However, updated national-level data capturing trends in conventional prenatal testing methods are limited. We aimed to assess the current landscape of prenatal genetic testing in Japan. To update the national data, we compiled test volumes from five major high-volume laboratories that analysed prenatal genetic tests and conducted a supplemental nationwide questionnaire-based survey on ultrasound (US)-only screening between 2020 and 2023. Over this period, MSS declined from 34,887 cases in 2018 to 25,553 in 2023, AC from 16,454 in 2014 to 5620 in 2023, and CVS from 2149 in 2015 to 1167 in 2023, whereas US-only screening increased slightly to >10,000 cases annually. The chromosomal abnormality detection rate among AC cases increased from 8% during 2006–2014 to 20.0% in 2023, with trisomy 21 comprising 43.6% of the cases. During the same period, the proportion of mothers aged ≥35 years increased from 14.0% in 2003 to 30.4% in 2023, whereas the proportion of national live births decreased by 35.3%. Thus, declining test volumes cannot be attributed solely to demographic changes but also reflect the influence of NIPT uptake, improved pretest risk stratification, and changing reproductive decision-making supported by expanding genetic counselling. This study provides foundational data for future prenatal genetic testing practices and policies in Japan.

医療・健康
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